Hemodilution for Acute Ischemic Stroke: Four Empirical Cases Report

血液稀釋法用於急性缺血性腦中風－四病例報告

劉安邦(An-Bang Liu) ； 林堅熙(Chein-Hsi Lin) ； 林隆義(Roy Lin) ； 張佐文(Tzo-Win Chang)

《慈濟醫學雜誌》 5卷4期 (1993/12) Pp. 295-301

https://doi.org/10.6440/TZUCMJ.199312.0295

摘要

血液稀釋法自1970年起用於治療缺血性腦中風，其效果目前尚無結論，血液稀釋法根據補充液體量的多少；可以分為高體積血液稀釋法及等體積血液稀釋法。我們採用等體積血液稀釋法治療四名缺血性腦中風的患者；其中兩患者有漸進性左側中大腦動脈阻塞，另一名則為暫時性腦缺血，最後一位則為中大腦動脈完全阻塞的病人。患者除了接受放血治療外，我們同時給與血漿擴張劑－低分子量的Dextran-40，並補充大量液體。四名病人中除了最後一位外，其餘患者的病情在接受血液稀釋法後都獲得明顯的改善。

關鍵字

血液流體力學 ； 黏稠度 ； 缺血 ； 血液稀釋法 ； 放血療法

並列摘要

Hemodilution has been applied for acute ischemic stroke since 1970’s. the benefit of this management is still equivocal. Hemodilution therapy is classified into 2 groups, such as hypervolemic and isovolemic according to the volume of fluid supplement. Patients receive phlebotomy and plasma expander. Isovolemic hemodilution was used to treat four patients with acute ischemic stroke. Tow hundred and fifty ml of blood was withdrawn with supplement of Dextran-40 at the same time. Two of the patients had progressive problems of left middle cerebral artery occlusion. Their pre-treated hematocrits were 51.6% and 45.0% respectively. Significant improvement of clinical manifestationins was noted next morning. The other had frequent transient ischemic attacks (TIA’s). No more TIA’s occurred after hemodilution and his hematocrit was 45.0% before and 42.0% after hemodilution. The last patient had complete stroke of the left middle cerebral artery occlusion. No obvious benefits of hemodilution were noted in this patient.

並列關鍵字

hemorheology ； viscosity ； ischemic penumbra ； hemodilution ； phiebotomy